Prevention is better than cure and far cheaper The San Francisco Association for the Study and Prevention of Tuberculosis TUBERCULOSIS (CONSUMPTION) 1547 JACKSON STREET Between Polk and Larlcin PHONE FRANKLIN 3293 TUBERCULOSIS Tuberculosis is one of the most widely spread diseases that affects humanity. Consumption is tuberculosis of the lungs. In the City of San Francisco consumption causes 15 per cent of all deaths, 859 persons dying of this disease in the year 1910. The relation of deaths from it to those from the two next most prevalent contagious diseases, and their relative power for robbing the State of happiness and wealth is expressed partially by these proportional lines: Tuberculosis of the Lungs, 859 deaths in San Francisco, 1910. — — Typhoid Fever, 68 deaths in San Francisco, 1910. -^— — Diphtheria, 38 deaths in San Francisco, 1910. Be careful to avoid tuberculosis-infected air and houses as you are water and milk contaminated by typhoid germs. Consumption causes one death in every three occurring between the ages of twenty and. forty. Thus it finds most of its victims at the active working age, and carries off young men and women just entering upon the serious work of life, fathers and mothers of families, bread-winners and citizens at their most useful period. Consumption is more prevalent in certain climates and among certain races, but it spares no nation, no age, no occupation, no class of people. Consumption is a preventable and a curable disease. Consumption can be prevented. It can be cured, if taken in time. It is not necessary to leave San Francisco to be cured. All autho- rities now subscribe to the views advanced by Hippocrates, the father of medicine, who lived 460-377 B. C, viz., "If the patient (consumptive) is treated from the beginning he will get well." 2 NATURE OF THE DISEASE. The cause of tuberculosis is a living germ — a tiny plant which can be seen only through the microscope. This germ, called bacillus tuberculosis, usually gets into the body by way of the mouth, when we are improperly using it, instead of the nose, to breathe through, or when we put something into our mouths which is contaminated through previous use by a con- sumptive. Tuberculosis germs most "frequently lodge in the air-passages of the lungs. They may also get into the glands of the neck, attack the throat, the bowels, kidneys, brain or other organs, or the bones or joints. It is always the same germ working in the same way to destroy different tissues. If the workings of the germs are not stopped, the capacity of the lungs and other organs to do their work is gradually reduced until death results. If it were not for the power that vigorous people, living healthy lives, possess to resist disease in general, it is probable that con- sumption would kill off whole communities. It is hardly possible that any single inhabitant of a city, where many have consumption, could entirely escape breathing into his lungs some living germs of the disease. Fortunately in the fresh air and sunshine these germs live only a short time, while in an ordinary room kept dark and close they may live months or even years. In the organs of the body when the germs are not killed imme- diately they produce little lumps called tubercles. In the lungs these grow, soften, break open and are expelled by coughing or otherwise. An ulcer or cavity containing many of the disease germs is left behind. In cure, nature builds a wall of -scar tissues about the tubercle or cavity. This wall becomes gradually thicker and thicker, growing towards the center until nothing is left but a scar. This means perfect cure. Until the scar tissue has thoroughly choked out the bacilli, it may break down at any time, leaving the bacilli free to continue their action at that place; then a relapse ensues. 3 NOT INHERITED. Many will be comforted to know that the disease is not inherited, as it was long thought to be. The children of parents who are consumptive or otherwise run down and weakened, frequently inherit narrow chests, a low vitality, or generally poor physique. If they are not especially cared for and protected against infection they are very likely to get the disease. Such children, and persons who are regaining health and strength after illness, or who are engaged in dusty work, should guard and build up their health systematically and persistently. President Roosevelt is a prominent example of one who developed a poor physique into an exceptionally fine one. The cases of so-called "hereditary consumption" are due to the disease being transmitted from one afflicted member of the family to another, either directly through personal contact, or through the medium of dirt and dust in the infected rooms. THE DANGER OF CARELESS SPITTING. "No one in health spits." — Dr. Flick. Except when one gets something nasty, like an insect or tobacco in the mouth, this is true. Many get into the habit of spitting and so wasting the saliva, which is meant to keep the mouth clean and to aid in digestion. Do not spit unnecessarily. When it is neces- sary, spit into a spittoon, a spit-flask, a cloth or paper that can be burned. Less safe than these, but far better than the floor or side- walk, is the gutter. Remember that while your spit may be only nasty and not dangerous, some one else who has a contagious disease that is commonly spread in this way, such as tuberculosis or diphtheria, is likely to follow your example. If women should spit as commonly as men do, how noticeable and disgusting it would be ! The consumptive in himself is almost harmless. He becomes harm- ful usually through bad habits, which are due, as a rule to ignorance. The consumptive at home or who walks about, works in offices or 4 shops, will not transmit his disease to those with whom he comes in contact if he takes proper care of his spit. THE VALUE OF FRESH AIR. The value of fresh air cannot be overestimated. Fresh air con- tains much oxygen ; bad air very little. Blood is made red and pure by breathing in the oxygen of fresh air. New body tissue is built out of such blood. It makes the muscles active and the brain quick. Therefore do not work or sleep where there is no fresh air. Do not stay in a theater, church, or other meeting place where your lungs are starved and poisoned for want of it. Breathe through your nose. That is what it is for. It smells bad air and so warns you. It filters out the dust and germs from the air breathed through it. The mouth has no filter for air, so those who breathe through it load their lungs with dirt and are more apt to get sick. CONDITIONS FAVORING THE SPREAD OF TUBERCULOSIS. It has been found that the vast majority of those infected are persons who have lived unhj^gienic lives, or who are compelled, in order to gain a livelihood, to work amidst unhealthful surround- ings, or too long hours. Healthy persons, living a proper life, when infected, frequently get over the disease so easily that they do not even know that they had it. Overcrowded, poorly ventilated houses, offices and workshops, inactive occupations with lack of regular exercise in the fresh air, trades causing much dust which, irritating the lungs, produce a condition favorable to the growth of the germ. Continued ex- haustion from overwork, poor food and insufficient clothing, uncleanness, and especially intemperance, are all factors in pre- disposing persons to consumption ; but it must be remembered that nothing can actually cause consumption except the entrance of the germ into the body. Consumption is common in persons living indoors and where thore is not enough fresh air. It is rare among 5 those living out of doors and sleeping in rooms well supplied with fresh air. No matter where the germs are, on floors, sidewalks, cars, on clothing or dishes, they are helped to live by dirt, dampness and darkness. On the other hand, sunshine, pure air and cleanliness are most valuable means of resisting and destroying the infection and preventing the disease. Keep your premises clean. Have a thorough spring and fall house-cleaning every year. Houses and rooms occupied by consumptives often become so infected with its germs that healthy persons afterwards occupying them often get consumption. Such rooms should, therefore, be dis- infected and renovated before being used again. In San Francisco there are many houses which have had cases of tuberculosis in succession. Such houses may fairly be said to be seats of infection and will probably continue to give consumption to their tenants until thoroughly disinfected and renovated. The only sure way of preventing the infection of premises or other persons directly is to carefully put all the germ-filled sputum out of harm's way by burning it. Do not dread being near a careful, clean consumptive. Do not regard this disease as contagious to the same extent as small -pox, diphtheria or scarlet fever. Much harm has been done through unwarranted fear of the consumptive, which has caused him to be avoided as a leper. Consumptives are only a source of danger through discharges from diseased tissues — chiefly the sputum, usually called spit — and if these are destroyed, ordinary contact with consumptive patients is practically free from danger. It has been proved that there is no infection in the ordinary breath of a consumptive. But the mouth should always be covered with a handkerchief or paper to catch the dangerous spray when coughing or sneezing. CONSUMPTION IS CURABLE. Consumption is curable when wise treatment is begun early. The first symptoms of the disease may be loss of appetite and steady loss of weight, fatigue on slight exertion, general feeling of 6 langour, lack of energy and ambition, rapid pulse, fever in the afternoon and evening, and a cough which is most noticeable in the morning. The cough may have existed for months with no evident injury to the general health; a slight, hacking cough, usually worse in the morning, may have occasioned so little annoyance, that the patient will deny having a cough at all or will remember it only after careful questioning. Consumption often follows pneumonia, "grip," measles, and whooping cough. As the disease progresses the symptoms become more distinctive. The evident wasting, the daily fever, the flushed cheeks, the night sweats and the continued cough and spitting, and determination that there are bacilli in the sputum indicate definitely the presence of the disease. Bleeding from the lungs is a common symptom of consumption and often the first one noticed. Any or all of these symptoms should cause the patient to seek at once the most competent medical advice. The local Board of Health make examinations of sputum without charge. The best treatment is out-door life, rest and plenty of good food under careful and constant medical supervision. This can be much better carried out at a sanatorium than at home, while going away "into the country to board" without competent and detailed medical supervision is not advisable. The San Francisco Association for the Study and Prevention of Tuberculosis located at 1547 Jackson Street, between Polk and Larkin Streets, was organized in 1908. Clinics for worthy patients are held every morning from 8 :30 to 10 a. m., and every Monday evening from 7 to 8 p. m. Our nurses visit the homes of patients and investigate the social conditions of the family, noting sun exposure, cubic air space, dis- posal of sputum, and facilities for outdoor treatment. To do all these things, we need money; for the success of the crusade against tuberculosis depends upon the financial aid it receives. Do your share by becoming a member of this Association, or at least obtaining one member. Annual membership $1.00 Life membership $100.00 Donations of any amount received. Please enroll me as an Active Member of San Francisco Associa- tion fot the Study and Prevention of Tuberculosis. I agree to pay $ annually. Name Address Mail to 1547 Jackson Street, San Francisco, Cal.